Artikel
ACKT – a novel score to predict prolonged mechanical ventilation after surgical treatment of meningioma in geriatric patients
ACKT – ein neuer Score zur Vorhersage einer postoperativen invasiven Beatmung nach chirurgischer Behandlung von geriatrischen Meningeompatienten
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Veröffentlicht: | 4. Juni 2021 |
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Gliederung
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Objective: Indication for surgical treatment in patients with intracranial meningioma must include both clinical aspects and an individual risk-benefit stratification, especially in geriatric patients. Prolonged mechanical ventilation (PMV) has not been investigated for its potential effects in patients with meningioma. We therefore have analyzed the impact of PMV on mortality in geriatric patients that had undergone meningioma resection.
Methods: Between 2009 and 2019, 261 patients aged ≥ 70 years were surgically treated for intracranial meningioma at our institution. PMV was defined as postoperative invasive ventilation of > 7 days.
Results: Postoperative PMV was present in 17 of 261 geriatric meningioma patients (7%). 25 geriatric patients (10%) died within 1 year after surgery. Multivariate analysis identified “postoperative PMV” (p<0.0001) and “preoperative corticosteroid medication” (p=0.03) as independent predictors for 1-year-mortality. A scoring system (“ACKT”) based on the variables Age, CRP-value, Karnofsky performance scale and Tumor size supports prediction of postoperative PMV (sensitivity 73%, specificity 84%).
Conclusion: PMV is a significant and independent predictor for increased mortality after surgical treatment of meningiomas in geriatric patients. Furthermore, we suggest a novel score (“ACKT”) to preoperatively estimate the risk of PMV occurrence which might help to guide future risk-benefit assessment and patient counselling in the geriatric meningioma population.